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The New Diabetes iSCREEN Tracker

December 2013. A remarkable new digital tool has come into use as the result of a  four-year collaboration between the electronic Child Health Network and SickKids. The Diabetes iSCREEN Tracker is designed to meet the needs of health-care providers looking after children in the Diabetes Clinic at SickKids. This busy outpatient Clinic serves approximately 1200 children and adolescents annually, with each patient averaging four visits over the year - and the number of patients climbing.


Diabetes in children, Types 1 and 2, is a complex chronic disease that requires continuous, precise monitoring and management by health-care providers. Adherence to rigorous treatment guidelines is crucial, as is ongoing screening for ancillary disorders, such as eye or kidney problems, that can occur as complications of the primary disease. Many types of data, such as lab tests, medication history, growth and development trends and vital signs must be considered in order to form an accurate clinical picture of an individual patient and provide optimal care.


Dr. Mark Palmert, Head of the Division of Endocrinology at SickKids was closely involved in the development of the iSCREEN Tracker, along with his colleague Dr. Farid Mahmud. He points out that up to now, the full range of information needed for clinical decision-making was not available in one location and often proved challenging to collect. Now the Diabetes Tracker puts all the relevant data in front of health-care providers in one readily apprehensible form via a consolidated Dashboard viewer. The iSCREEN tracks a checklist of up to 18 indicators, such as blood pressure, cholesterol and lipid levels, medication history, and height and weight trends, which are known to provide key information about a patient's health status.


In addition,  the Diabetes Tracker includes a host of special features to make the complicated monitoring and treatment of the disease more manageable. Says Dr. Palmert, "It not only gives you access to data about what's happened, it also tells you if something needs to be done - and why."


The Care Tracking screen with its checklist of indicators informs health-care providers if a test that was due has, in fact, been completed and includes a system of alerts for when a test is coming due - or is already overdue.  Clicking on the "History" button provides a list of previous tests and the option to drill down for further details about each one. Test results are  highlighted if they are abnormal. For certain indicators such as height and weight which change over the course of childhood development, the normal and abnormal ranges are displayed graphically via growth charts.


Dr. Palmert finds the teaching and reinforcing of knowledge that the iSCREEN Tracker provides to be especially noteworthy. If a test result is abnormal, the health-care provider can easily find advice on how to proceed. Clicking on the "Guidelines" button provides the clinician with the specific treatment and monitoring recommendations laid out in the Canadian Diabetes Association Guidelines.


Photo above left: eCHN Senior Managers engaged in their weekly review.

Photo above right: Members of MED team with eCHN Founding CEO pay tribute to standardization guru, Dr. Gilbert Hill (second from right).